Patient Payments:

4 Easy Ways to
Get Started
Presented By:
Ginny Shipp

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Getting Started with a Patient Pay Program

Setting goals

Who should be involved

Creating YOUR foundation

How to effectively talk to patients

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 Background

High Deductible Health Plans (HDHP)…

…Lead to Increased Patient Responsibility

Facts:
• In just 5 years, patients covered by HDHPs
increased from 19.2% to 32.5%
• This increased the patient out of pocket expense by
78%

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Solution

• Be more proactive in
collecting patient balances

• Strengthen the front end of

your patient revenue cycle

“The secret of getting ahead is

getting started.”
-Mark Twain

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“I want to, but…
• …we get most of our money from
insurance payments.”
• …my staff will never go for it.”
• …our patients will not like it and we
may lose them.”
• …I don’t have time to implement this
program.”
• …we won’t be able to keep up with a
program like this.”

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“…we get most of our money from insurance
payments”

Every penny counts!

What could your practice do with even

$5000 more per month, or $60,000 per
year?
• Additional staff member
• New equipment
• More clinical training
• Easier to pay the bills!

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 “…my staff will never go for it.”

Why is change so hard?

Longevity = Good
Unconscious bias
Uncertainty
Fight or Flight
• Only 9% of patients with severe heart disease modify their
behavior
• 70% of change initiatives fail because of people resistance, not
because the ideas weren’t good

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“…our patients will not like it and we may
lose them.”

It‟s a change for your patients, too!

Getting buy-in –

• Create understanding
• Communicate how it will affect them
• Collaborate

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“…I don’t have time to implement this
program.”

You don‟t have time “If you do

not to! what you
The future is now to always did,
improve your cash you will get
flow what you
always got.”
- Albert Einstein

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“…we won’t be able to keep up with a
program like this.”

Planning is everything!

• Take time to prepare

• Allow input from team
• Anticipate needs

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Resistance to Change

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Your Brain and Change

We are wired to maintain the

status quo
• Survival
• Easy way out

However…we CAN change and adapt

Neuroplasticity – our brain’s ability
to change as a result of our
interactions with the environment

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Where You Focus Your Attention, Change
Happens

Natural tendency to move towards

equilibrium and away from change

Change takes:
• Effort
• Laser focus over a period of time
• Mindful action

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Motivating Change

Communicate

Promote the
Why are we
change –
changing?
Campaign!

Address:
“What‟s in it Listen to
for me?” concerns

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Set Goals

• Customized Goals:
What will work best in YOUR organization?
Example: Collect 50% of total patient responsibility
at time of service

• Sustainable:
How will this change work over time?
Example: Front-desk staff will know what the total
patient responsibility is prior to the patient’s arrival

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Set Goals

1. Review your current patient A/R – what is

getting into the 90+ bucket?
2. Know your numbers –
Payer mix
Patient mix
Old A/R vs. Future A/R

3. Be realistic
What can my staff manage?
What can my patients pay?

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Who Should Be Involved

Patient collections is a group effort!

Touch points:
• Scheduling and Registration
• Check-in
• Clinical team
• Check-out
• Billing office

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Who Should Be Involved
Typical responsibilities:
Scheduling & registration
• Verbally discuss financial policy; patient should be prepared to pay
Check-in
• Verbally explain financial policy and have patient sign
• Collect money based on policy
Clinical team
• Answer questions according to financial policy
Check-out
• Review financial policy
• Present options for patients to pay
• Collect money based on policy
Billing office
• Answer questions according to financial policy
• Present options for patients to pay
• Set up payment plans

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Create YOUR Foundation

Financial Policy:
Driven by your Goals >> The driver of
your patient pay program

• Refer to your goals

• Walk through the patient experience to
consider all the „what ifs…‟
• Be aggressive, but gentle

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Create YOUR Foundation

Technology and Automation

Card on File –
Make this your “Payment Guarantee” plan

• Ensure future payments

• Offer flexibility for patients
• Create automation

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Create YOUR Foundation

Automation is key!

• Secure card on file

• Payment plans
• Secure authorized payments
• Electronic statements
• Care estimates
• Online bill pay

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Create YOUR Foundation

Messaging and Scripting:

Clear and Often

Check for understanding

Train your team!

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Create YOUR Foundation

Cultural change – re-wiring the brain

• Relabel – re-train automatic responses
i.e. “I don’t want to ask this patient for money.”
becomes “I know how to ask this patient for money.”
• Refocus – (blaze a trail)
Train and retrain until it becomes easier and intuitive
• Support –
Be there for your team: observe and intervene as
needed
• Positive feedback –
Recognize and repeat appropriate behaviors

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Talking to Patients

• Explain policy in simple terms (if/then)

• Teach
• Speak kindly, but with conviction (need a
strong staff)
• Listen to patient concerns (conversations
about money can be difficult)
• Stick to your plan (front-end
conversations are easier than back end)

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Talking to Patients

Be prepared with FAQs

1. I have never had a Dr‟s office ask me to keep a card on file.
We realize this is a new policy for a medical office, but we do not hold any funds or charge
anything to your card until you have a balance due.

2. How do I know my credit card will be safe?

We use a third party merchant who is PCI-DSS (Payment Card Industry Data Security
Standard) compliant. Our staff never has access to your card with the exception of the last 4
digits.

3. How will I know when you are going to charge me?

You will get an email notification that your card will be charged, including the amount and
the date it will be charged.

4. What if I have a really large bill?

We are always happy to discuss setting up a payment plan. Our system allows your card to
be charged automatically each month for the amount determined in the payment plan.

5. I always pay my bills, why do I have to do this?

We have to be fair and apply the same policy to all patients. We appreciate those patients
who pay their bills on time. This will give you the convenience of not having to receive a bill
or send a check.

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Summary
• Set your goals:
− Look at current A/R, staffing, and process

• Identify who will be involved:

− Involve as many people as possible and be sure everyone is on the
same page

• Create YOUR foundation:

− Work through all of the details anticipating all possible financial
scenarios

• Create scripts for talking with patients:

− Be confident and gentle; cover points that keep the patient in mind,
not just the practice revenue

• Implement thoughtfully:
− Notify patients of start date; train and practice
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Sources

National Center of Health Statistics

Milliman Medical Index

Langley Group (Neuroscience of Change)

Matthew E. May – Strategic Facilitation &

Ideation

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